Provider Demographics
NPI:1386166759
Name:MASSEY, ALEXIA (CSW)
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:ALEXIA
Other - Middle Name:
Other - Last Name:ZAHARIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:165 N 1650 W APT J101
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-5836
Mailing Address - Country:US
Mailing Address - Phone:909-273-5060
Mailing Address - Fax:
Practice Address - Street 1:80 W CANYON CREST RD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:UT
Practice Address - Zip Code:84004-1980
Practice Address - Country:US
Practice Address - Phone:801-855-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10382235-3503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker